Search

Digital mental health interventions (DMHIs) have surged in popularity over the last few years. However, adherence to self-guided interventions remains a major hurdle to overcome. The current study utilized a phased implementation design, incorporating diverse samples and contexts to delve into the engagement challenges faced by a recently launched online mental health platform in Brazil with self-evaluation forms. Employing an iterative mixedmethods approach, including focus groups, online surveys, and think-aloud protocols, the research aims to evaluate user satisfaction, identify barriers to adherence, and explore potential hybrid solutions. Engagement in the platform was evaluated by descriptive statistics of the number of instruments completed, and qualitative interviews that were interpreted thematically. In the fully selfguided mode, 2,145 individuals registered, but a substantial majority (88.9%) engaged with the platform for only 1 day, and merely 3.3% completed all activities. In another sample of 50 participants were given a choice between online-only or a hybrid experience with face-to-face meetings. 40% of individuals from the hybrid group completed all activities, compared to 8% in the online-only format. Time constraints emerged as a significant barrier to engagement, with suggested improvements including app development, periodic reminders, and meetings with healthcare professionals. While the study identified weaknesses in the number and length of instruments, personalized results stood out as a major strength. Overall, the findings indicate high satisfaction with the mental health platform but underscore the need for improvements, emphasizing the promise of personalized mental health information and acknowledging persistent barriers in a digital-only setting. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has had a marked influence on the nature of psychotherapy in the transition from predominantly in-person services to predominantly remote, telemental health services, to an intermediary hybrid model. Increased availability of telehealth services has been denoted a point of equity in meeting service needs of diverse groups of people across the United States. However, some University and College Counseling Centers (UCCCs) have rapidly rolled back telemental health provisions in favor of in-person or hybrid models of practice, even amidst increased use of counseling services, pressure to expand service availability, and difficulties with clinical staff retention. To explore this phenomenon, 75 UCCC administrators in the U.S. were surveyed to elucidate the nature of remote staffing in UCCCs, including administrative perspectives regarding barriers to hiring permanently remote staff (PRS). Five thematic barriers to hiring PRS were identified: Institutional Roadblocks, Team Ethos, Equity in Clinical Duties, Student Demand, and Service Quality Concerns. A majority of these barriers coded into categories that were chronic and autonomy-limiting in nature. Implications and recommendations for UCCCs and college student wellness are discussed. [ABSTRACT FROM AUTHOR]

Objective: This study explored how Canada's postsecondary institutions have informed students about campus mental health (MH) services via websites and social media during the COVID-19 pandemic. Methods: We conducted a Web-based environmental scan of 20 universities and 24 colleges across the province of Ontario, Canada, between October 2020 and July 2021. Results: 91% of the institutions offered virtual counseling services and 84% offered general psychoeducational resources, whereas only 55% had COVID-19 specific MH resources. Larger institutions had more MH support to students than small schools. There was a trend toward outsourcing counseling and emergency services to external professionals via apps and hotlines. Limited MH information was available for out-of-province and international students. Conclusion: It is vital for equitable campus MH services to address unique MH challenges associated with the crisis and intentional outreach to students with special circumstances. Schools can leverage peer support and self-help to promote student mental well-being. [ABSTRACT FROM AUTHOR]

Objective: The Medicare Benefit Schedule (MBS) telehealth items were expanded in March 2020 during the COVID-19 pandemic. We measured the use of MBS telepsychiatry items compared to consultant physician telehealth items within the context of these item changes, to understand differences in telepsychiatry and physician telehealth utilisation. Methods: Monthly counts of face-to-face and telehealth (videoconferencing and telephone) MBS items for psychiatrists and physicians from January 2017 to December 2022 were compiled from Services Australia MBS Item Reports. Usage levels were compared before and after telehealth item expansion. Usage trends for MBS telepsychiatry and physician telehealth items were compared in time-series plots. Results: Telehealth item expansion resulted in a greater rise of telepsychiatry services from 3.8% beforehand to 43.8% of total services subsequently, compared with physician telehealth services (from 0.6% to 20.0%). More physician telehealth services were by telephone compared with telepsychiatry services. Time-series of both telehealth services displayed similar patterns until mid-2022, when physician telehealth services declined as telephone items were restricted. Telepsychiatry services consistently comprised a greater proportion of total services than physician telehealth services. Conclusions: MBS psychiatrist services showed a more substantial and persistent shift to telehealth than physician services, suggesting a greater preference and use of telepsychiatry. [ABSTRACT FROM AUTHOR]

Access to smartphone and data plan services may impact levels of connection and opportunities for health management for patients with a diagnosis of a serious mental illness. Such smartphone-based services provide opportunities that extend the reach of physical and mental health care programs. The purpose of this study was to explore barriers and facilitators faced by individuals with mental health challenges when accessing Medicaid SafeLink smartphones and data plans. Interview guides were developed using the Consolidated Framework for Implementation Research. Individual semi-structured interviews were conducted to collect qualitative data on 18 participants' experiences with SafeLink services. Two main themes were identified– barriers and facilitators. Sub-themes included monthly data limits, followed by account management (barriers), opportunities for safety, and connection (facilitators). Massachusetts SafeLink policies provide individuals with an opportunity for smartphone ownership. However, results imply that expanding the current policy's usage limits may provide additional opportunities for connection and access to health services. [ABSTRACT FROM AUTHOR]

Despite research supporting the efficacy of weekly outpatient videoconferencing-based cognitive behavioral therapy (VCBT), limited evidence exists about the benefits of leveraging VCBT for brief intensive formats. We examined the effectiveness of an intensive outpatient VCBT targeting pediatric anxiety and OCD. Quasi-experimental design was used to compare outcomes of intensive, in-person, group-based cognitive-behavioral therapy with medication management and caregiver guidance pre-pandemic, to a similar VCBT peri-pandemic (n = 130). Pretreatment and posttreatment assessments included patient- and caregiver-report of anxiety and functional impairment. Analyses of covariance were conducted, examining changes in anxiety and impairment between treatment groups, controlling for admission levels. No significant differences in posttreatment anxiety or impairment were observed between conditions. This study illustrates that intensive, group-based treatment for pediatric anxiety and OCD using VCBT is associated with comparable reductions in anxiety and impairment. It marks a crucial step toward providing broader access to quality care for youth in need. [ABSTRACT FROM AUTHOR]

Losses that took place during the covid 19 pandemic are recognised as "bad deaths". They are characterized by physical discomfort, difficulty breathing, social isolation, psychological distress and ineffective care. The experience of grief has been even more challenging during the covid times as compared to the usual grief prior to the pandemic due to the lack of resources that assist in coping. Lack of social support, uncertainty about the future, lack of routine, and absence of mourning rituals deny the bereaved with the basic opportunity to grieve adaptively. Enhancing advance care planning may help dying patients to receive effective care. Virtual funeral services, extending support through telephonic conversations, online psychotherapy and encouraging continuing bonds with the deceased assist individuals who experience grief and bereavement. The current chapter focuses on expanding awareness about the nature of grief during the pandemic and understanding effective measures to mitigate complicated grief across various subgroups of the society who experienced grief as a result of the covid-19 pandemic. [ABSTRACT FROM AUTHOR]

Background: To explore perspectives of work readiness, including readiness to work rurally, among health students trained in Australia during the COVID-19 pandemic. Methods: Participants were allied health, medicine, and nursing students in the later years of their degree (third, fourth or final year of an undergraduate entry to practice degree, or second year of postgraduate entry to practice degree), where training is clinically immersive. These students had completed a University Department of Rural Health facilitated rural and remote placement between January 2021 and October 2022. They participated in a cross-sectional online survey (n = 426), comprising Likert-scale questions. Interested survey respondents participated in a semi-structured interview (n = 34). Multiple logistic regression was conducted to examine the predictors of work readiness within the survey, and interview data was analysed via reflexive thematic analysis. Results: Among survey respondents, 69.7% felt they would be ready to be a health practitioner when the time came to graduate and 71.8% felt clinically prepared to work in a rural location. Concerns about having developed enough clinical skills on placements to competently practice on graduation and being able to continue studying their course during the pandemic were both predictive of work readiness and feeling clinically prepared to work rurally. Four themes reflecting factors impacting work readiness were developed from interview data: (1) 'I'd estimate probably a 20–30% reduction in face-to-face handling practice over the course of all of my placements' encompassed student concerns regarding the collective impact of cancelled placements and lower patient attendance at healthcare facilities on clinical skill development; (2) 'Two and a half years of sitting behind a computer' related to student experiences of superficial learning and cohort disconnectedness due to online course delivery and loss of on campus simulations; (3) 'I'll still need like a lot of support in my grad year' related to students recognising the need for support and supervision post-qualifying to bridge the gaps in their learning; and (4) 'We are the COVID nurses' encompassed student recognition of skills gained including communication skills, competence with technology and telehealth, knowledge of infection control, and work readiness skills (e.g. adaptability and resilience) as a result of training during the global pandemic. Conclusions: Universities can support work readiness during pandemic circumstances by fostering clinical skills development through continuation of quality placement experiences and face-to-face curriculum delivery. Although health graduates trained during the pandemic are likely to have a range of additional work ready skills, health services will need to proactively support their transition into the workforce in the coming years. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 pandemic disrupted traditional medical education, prompting innovative teaching methods for practical skills training. The teledidactic TELUS ultrasound course, launched in 2020–2021, aimed to provide remote instruction in ultrasound techniques. Objective: This study assesses the long-term impact of the teledidactic ultrasound course conducted during the study years on current clinical practice. Methods: In 2024, a follow-up survey was conducted with former TELUS course students now practicing as physicians across various specialities. Participants rated their confidence in ultrasound examinations and its frequency in practice. Results: 21 out of 30 participants (70%) completed the survey. 71.4% rated the course experience as excellent (5/5 points). Most reported significant learning gains, especially in the FAST module. While all agreed the course enhanced their ultrasound skills, its impact on patient care received mixed reviews. Frequency of ultrasound use varied widely among specialities, with high use in surgery and internal medicine but less in psychiatry, neurology, and ophthalmology. Notably, 42,9% had not pursued further ultrasound training post-course. Conclusion: The teledidactic ultrasound course effectively provided remote education, integrating skills into practice. Mixed reviews on patient care impact and speciality-specific ultrasound use suggest sustained integration depends on relevance and ongoing education. Self-assessment results support online ultrasound courses, indicating potential use in resource-limited or geographically constrained settings. [ABSTRACT FROM AUTHOR]

Background: The COVID‐19 pandemic prompted a surge in telehealth utilization. However, language barriers have emerged as a potential obstacle to effective telemedicine engagement, impacting millions of limited English proficient (LEP) individuals. Understanding the role of language spoken in telehealth outcomes is critical, particularly in cancer care, in which consistent follow‐up and communication are vital. The primary objective was to assess the impact of telehealth utilization and primary language spoken on clinical outcomes in cancer patients. Methods: This study utilized a retrospective cohort design, encompassing cancer patients seen at the Chao Family Comprehensive Cancer Center between March 1, 2020, and December 31, 2022. The study incorporated both in‐person and telehealth visits, examining the association between encounter type and clinical outcomes. Results: The study included 7890 patients with more than one outpatient visit during the study period. There was decreased telehealth utilization in non‐English speaking cancer patients throughout the pandemic. Increased telehealth utilization was associated with higher rates of admission, irrespective of cancer type. Additionally, telehealth visits were associated with longer duration of subsequent admissions compared to in‐person visits. Spanish‐speaking patients utilizing telehealth had higher rates of re‐admission compared to English speakers utilizing telehealth. Patients who died had higher rates of telehealth utilization compared to patients who survived. Conclusions and Relevance: This study demonstrates that primary language spoken is associated with differences in telehealth utilization and associated outcomes in cancer patients. These differences suggest that the interplay of telehealth and language could contribute to widening of disparities in clinical outcomes in these populations. The study underscores the need to optimize telehealth usage and minimize its limitations to enhance the quality of cancer care in a telehealth‐driven era. [ABSTRACT FROM AUTHOR]

Background: Telehealth has emerged as a vital alternative to traditional healthcare delivery, particularly for rural and underserved populations. While efforts to enhance telehealth accessibility have primarily focused on technological solutions, the effectiveness of its telehealth and the role of physician training in bridging racial and ethnic disparities in telehealth usage remains underexplored. This study evaluates the impact of a trained-physician-delivered, age-friendly telehealth model on healthcare accessibility and outcomes. Methods: A retrospective analysis was conducted on 214 older patients (60+) at an urban primary care facility in Nevada, USA. Patients received telehealth services from either trained or non-trained physicians, with the trained group utilizing a 4M-based telehealth model focusing on Medication, Mentation, Mobility, and What Matters. Results: Findings revealed lower exposure to both general and 4M-based telehealth among Hispanic and Asian patients compared to their white counterparts. Telehealth usage did not significantly reduce hospital or emergency department visits overall. However, certain types of 4M-based telehealth, such as What Matters and Medications, reduced hospital and ED visits. Implications: The development and implementation of telehealth education curricula for healthcare providers could make telehealth more accessible to minority patients, potentially reducing unnecessary emergency department visits and addressing disparities in telehealth access. [ABSTRACT FROM AUTHOR]

Objectives: This study examined the level of technology proficiency amongst healthcare professions students. Additionally, the study provides an evaluation of the pilot implementation, as well as the effect of a 7-module telehealth course on the level of adoption and future use of telehealth amongst future Australian healthcare workforce. Methods: Students from four health-sciences departments at the University of Melbourne, Australia, participated in this pilot study by completing the course and an online questionnaire, which included both structured and open-ended questions. The questionnaire included: 12-items on socio-demographic and Internet utilization; 34-items about acceptance and use of telehealth adapted from the Unified Theory of Acceptance and Use of Technology (UTAUT2) questionnaire; and 22-items about confidence in using the Internet and ICT, adapted from Technology Proficiency Self-Assessment Questionnaire for 21st Century Learning (TPSA-C-21). Results: The evaluation included 26 students who expressed confidence in their Internet/ICT skills They showed enthusiasm for telehealth and recognized its potential benefits, but also emphasized the value of face-to-face interactions. They requested information on legal and aspects and additional learning. Post-test assessments indicated improvements in overall acceptance and use attitudes towards telehealth and on six dimensions of the UTAUT2 instrument. Participation in the course indicated improvements in students' overall acceptance and use attitudes and on six of the ten dimensions of the UTAUT2 instrument (p < 0.05). Conclusion: This preliminary evaluation indicated that the telehealth course was a positive and enjoyable learning experience for students with appropriate structure and information. The course was successful in improving students' acceptance and use of health technology. The study identified areas in which further development might be required. As such, the course represents a helpful approach for telehealth training among health professions students. Further evaluation with larger samples is required. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 pandemic accelerated the formal integration of telehealth into education curricula and training programs, prompting the need to reevaluate the current landscape and inform a research agenda. We developed a survey to assess telehealth education and training curriculum, competencies, certification, and research across pediatric medical centers. Methods: Questions were derived from a previously published national survey and de novo. The survey was distributed across national pediatric professional associations. Results: In total, 32 respondents representing medical centers (86.5%) were providing telehealth education and/or training. Most were internally developed didactic (78.6%) and experiential (64.3%) curricula. Respondents who included education and/or training in telehealth research protocols and conducted telehealth research (74%) reported mandatory or optional training in tele-research. A form of certification was preferred by most organizations (>60%). Conclusion: Telehealth education and training are key factors within current and future service development, provision, and research to demonstrate competencies and positively impact patient care. [ABSTRACT FROM AUTHOR]

Objective: We aimed to evaluate medical school students’ knowledge and approaches regarding telehealth. Method: In this descriptive study, an electronic survey was conducted among students attending the Faculties of Medicine at Health Sciences University. The first part ofthe Form included questions evaluating individual characteristics and telehealth approaches, and the second part included opinions and suggestions regarding telehealth usage topics. Results: Of 698 participants, 435 (64.9%) students were in the preclinical period. One hundred nine (15.6%) believed they had sufficient knowledge about telehealth while 399 (57.2%) believed that telehealth should be included in medical education. When asked about their opinions on using telehealth in their professional careers, 298 (42.7%) stated that they considered using them. Those who perceived themselves as having sufficient knowledge about telehealth were more inclined to consider using it more in their professional careers (p=0.000). Participants who believed that healthcare services could be provided through telehealth were more likely to think that disease monitoring would be better, patient follow-up quality would improve, unnecessary hospital admissions would decrease (p<0.05). Conclusions: The majority of medical faculty students lack sufficient knowledge about telemedicine and believe that education on this topic should be included in the medical curriculum. It is suggested that incorporating pre-clinical courses on telemedicine and providing internship opportunities in practical settings would effectively address this gap. [ABSTRACT FROM AUTHOR]

Remote health consultation (also known as teleconsultation) is a fundamental part of telemedicine. The information technologies and Internet facilitate the adoption of teleconsultations in medical practice. During the Covid-19 pandemic many countries have used the remote health consultations to manage various medical conditions which significantly accelerated the development of these telemedicine services. The aim of the present study is to review teleconsultations’ characteristics and advantages as well as some of the areаs of their applications. The results show that remote health consultation covers a wide range of medical activities not only related to consultations and diagnostics from a distance in rural regions. Teleconsultations are also beneficial in providing protection and support for at-risk patients via communication through a variety of technologies in areas such as psychiatry primary care radiology pathology cardiology dermatology etc. However, a lack of a regulatory framework and a payment regulation for telemedicine services limits their use. [ABSTRACT FROM AUTHOR]

Objective: The present study aims to present a novel cognitive-behavioral intervention protocol focused on treating social isolation through telematic interaction, thus overcoming common barriers characteristic of face-to-face interventions. Methods: We examined current literature about face-to-face and telematic psychotherapeutic interventions for the treatment of social isolation in early adulthood. Current evidence is mixed, suggesting the need to develop novel interventions focused on patients' cognitive functioning. Moreover, telematic interventions are promising candidates for overcoming common barriers intrinsic to the condition of social isolation. Results: The present 8-session model inspired by cognitive behavioral theoretical models and cognitive interventions currently present in the literature is thought to help socially isolated adult patients reduce clinical symptoms associated with the condition and lead to a reduction in the avoidance of social situations, leading to an improvement of the quality of life. Conclusion: We presented a telematic psychotherapeutic intervention aimed at helping adult patients suffering from social isolation who are unable to seek help from national health systems and face-to-face interventions, thus overcoming barriers intrinsic to social isolation. The present cognitive-behavioral treatment protocol has been developed in the context of a randomized clinical trial ongoing in Italy, aimed at implementing and testing the feasibility and effectiveness of multimodal digital interventions for treating social isolation. [ABSTRACT FROM AUTHOR]

Objective: The Objective Structured Clinical Examination (OSCE) has been used for clinical assessment of a broad range of medical student competencies in Psychiatry and Addiction Medicine. However, there has been little research into online assessments. We investigated the virtual OSCE (v-OSCE) from the user perspective to better understand its acceptability, usefulness, benefits, challenges and potential improvements. Methods: At the conclusion of the v-OSCE, all participants (medical students, examiners and simulated patients) were invited to participate in a brief online survey, based on the Technology and Acceptance Model. Freeform qualitative feedback was also obtained to explore participants' experiences and attitudes. Results: Participants reported the v-OSCE was acceptable, efficient, convenient and easy to use. It was perceived as useful for demonstrating students' interviewing skills and interacting with the simulated patient. Benefits included greater convenience, reduced stress and travel time. Challenges were similar to those experienced in 'real world' telepsychiatry, primarily related to assessment of non-verbal cues and emotional prosody. Conclusions: Our findings inform recommendations for improving online examinations. These include increased preparation, practice and professionalism, to better simulate the in-person experience. Study credibility was strengthened by the triangulation of qualitative, quantitative and psychometric data. [ABSTRACT FROM AUTHOR]

Background: The worldwide COVID-19 pandemic has initiated a change in medical education and the development of new teaching concepts has become inevitable to maintain adequate training. Objective: This pilot study aims to compare teledidactic teaching with traditional face-to-face teaching for abdominal, thoracic, and thyroid ultrasound. Design: Concurrently, a teledidactic and a face-to-face ultrasound course were held. The students completed seven 90-min modules using mobile ultrasound probes (Butterfly IQ). Each module consisted of a lecture, a demonstration of probe guidance, and independent training. Participants: A total of thirty medical students took part in the study and were randomly assigned to a teledidactic and a face-to-face group. Main Measures: An objective structured assessment of ultrasound skills (OSAUS) was performed as a pre-test and as the final exam and ultrasound images obtained during the exam were evaluated using the brightness mode quality ultrasound imaging examination (B-QUIET) scale. Key Results: No significant difference between the two cohorts on the OSAUS final exam was shown (p > 0.05 in all modules). There was a significant difference in the assessment of the images in the focused assessment with sonography for trauma (FAST) (p 0.015) and aorta (p 0.017) modules. Students in the teledidactic group performed better in both modules, scoring 33.59 (± 2.61) out of 44 in the module FAST (face-to-face group 30.95 (± 1.76)) and aortic images averaged 35.41 (± 2.61) points (face-to-face group 32.35 (± 3.08)). Conclusions: A teledidactic course for abdominal and thoracic ultrasound examinations is equally effective to traditional face-to-face teaching in this pilot study. Digital implementation with a portable ultrasound machine could be a great opportunity to promote ultrasound education worldwide and over great distances. [ABSTRACT FROM AUTHOR]

The Philippines faces a significant unmet need for mental health care services, especially in remote and underserved areas with limited access to traditional in-person psychiatric services. Telepsychiatry offers a potential solution for bridging this gap and improving access to care. This study aimed to evaluate the telepsychiatry service in a Level 1 government hospital in southern Philippines and assess its feasibility for improving mental healthcare access. This evaluation study used a mixed-methods approach, including quantitative analysis of patient demographic data and psychiatric diagnoses retrieved from medical records (2018-2021), as well as qualitative in-depth interviews and focus group discussions with patients, guardians, and hospital staff. A SWOT (strengths, weaknesses, opportunities, threats) analysis was also conducted to assess areas for improvement. The majority of patients were between 18-35 yr old, male, and single. The most common diagnoses were schizophrenia spectrum and other psychotic disorders, followed by depressive and anxiety disorders. Key issues included medicine shortage, lack of communication, and poor Internet connectivity. However, stakeholders cited advantages such as access to free consultations, timely diagnosis, and potential for service scaleup. This study features telepsychiatry's potential for enabling better mental health care access in resource-constrained areas of the Philippines. It is the first to demonstrate telepsychiatry service provision from a specialist hospital to a Level 1 government hospital in the country. However, sustained multi-sector and multi-level coordination is crucial for long-term viability. Recommendations for enhancement and future research directions are provided. [ABSTRACT FROM AUTHOR]

The challenges faced by overseas Filipino workers (OFWs) expose them to abuse, harming their mental wellness. Telepsychiatry offers hope by allowing prompt diagnosis, management, and treatment of mental health issues. Yet, the acceptability of this technology among OFWs has not been studied, and specialized psychiatric services for them are scarce. This study assessed telepsychiatry acceptance among OFWs in Kuwait. Using a cross-sectional design, participants with mental health concerns in a Philippine Embassy shelter were selected. Tailored telepsychiatry software facilitated secure online video consultations and psychotherapy sessions with a Philippines-based psychiatrist. Acceptance was measured with the telemedicine satisfaction and usefulness questionnaire. Fifty-five (55) female OFWs participated; most were household service workers (n = 53; 96.36%) with a median age of 35. Mental health disorders were diagnosed in 22 participants (40%)-including acute stress disorder (n = 14; 25.45%), major depressive disorder (n = 5; 9.09%), brief psychotic disorder (n = 1; 1.82%), post-traumatic stress disorder (n = 1; 1.82%), and adjustment disorder (n = 1; 1.82%). Acceptance-wise, the majority of the participants expressed satisfaction with the telepsychiatry service provided (mean = 4.77; SD=0.48). This pioneering research demonstrates the viability of telepsychiatry in providing vital psychosocial support to distressed OFWs in Kuwait. Sustaining and expanding this service across various countries is essential to ensure access to culturally sensitive and responsive mental health resources, thereby promoting mental health equity and the overall well-being of migrant workers. [ABSTRACT FROM AUTHOR]

Purpose: Rural communities are disproportionately impacted by acute shortages of mental health providers. This problem, combined with complex behavioral health conditions, elicited the need for a university-based, remote telepsychiatric traineeship for newly board certified psychiatric–mental health nurse practitioners (PMHNPs). Method: The Psychiatric Advanced Practice Registered Nurse TechNology Enhanced Residency (PARTNER) Program was developed to advance behavioral health equity by increasing state-wide access to care, removing geographical barriers, and enhancing PMHNP workforce readiness by strengthening trainees' ability to manage complex behavioral health conditions. Results: In a southeastern state over a period of 3 years, six PMHNPs cumulatively provided behavioral health services to 1,195 patients, managed >118 diagnoses, and completed 3,535 visits, with 95.6% of visits comprising provision of care to patients residing in rural areas. Conclusion: Care was provided through the implementation of a collaborative-interdisciplinary-care model provided by route of telehealth and comprising a partnership between PMHNPs and patients' primary care providers. The training program enhanced providers' clinical proficiency, improved patient outcomes, and increased the number of skilled providers trained to manage patients with complex behavioral health conditions. [Journal of Psychosocial Nursing and Mental Health Services, 62(8), 19–24.] [ABSTRACT FROM AUTHOR]

Background: Securing access to sufficient and focussed learning experiences is a perennial challenge for medical trainees. This challenge was accentuated during the COVID‐19 pandemic lockdowns and with physical isolation processes that decreased in‐person patient presentations and a shift to telehealth consultations. This situation has prompted the need to optimise the available experiences and educational responses to overcome the limitations in the number, quantum and range of available clinical learning experiences. Methods: Semi‐structured interviews were conducted with medical practice teams in four rural general practices to understand how medical trainees' education in rural general practices can be sustained in such circumstances. Findings: Key considerations included optimising the available experiences to assist medical trainees to generate the kinds of mental models needed by trainees to conduct medical work, and particularly, when it became even more restricted through remote or physically distanced consultations. It also identified lessons learnt during COVID‐19 pandemic lockdowns to inform and improve the provision of trainees' experiences in such practices. Discussion: Providing experiences for trainees to participate fully in clinical activities is imperative. A sequenced set of experiences was proposed to incrementally prepare trainees to engage in and conduct clinical consultations remotely using digital technologies. Conclusion: Such an approach may not always be easy or possible to enact but offers a pathway of experiences most likely to lead to positive outcomes for the trainees whilst maintaining patient care and safety considerations. [ABSTRACT FROM AUTHOR]

Introduction: Assessment is crucial in the identification of children with potential delays/disorders and allows speech-language pathologists the opportunity to provide early intervention when indicated. For this reason, inaccessibility to formal assessments can be detrimental to the development and progression of overall communication skills for children with language disorders. The COVID-19 pandemic highlighted the need for increased telehealth services and how the provision of these remote services offers a much-needed alternative to face-to-face services for both clinicians and families. Method: A systematic procedure involving online literature searches in four electronic databases was employed to identify studies for inclusion in this review. Inclusion criteria were as follows: (1) preschool or elementary pediatric participants, and (2) involve the delivery of language-based assessments via telehealth. Additionally, the search was limited to studies written in English, dated 2010 and newer, and published in peer-reviewed journals. Results: The results of the systematic review showed there was no significant difference between standard scores and behavioral ratings for both face-to-face and telehealth assessments. The studies reviewed determined that telehealth delivery was feasible and presented adequate reliability with high levels of agreement between assessment scores obtained via telehealth and face-to-face. Conclusion: Current research suggests that there is no significant difference between remote and face-to-face assessment administration. Additional research is needed to examine the feasibility and reliability of conducting language-based assessments via telehealth in bilingual children, children younger than four years of age, and in different environments, such as schools or clinics. [ABSTRACT FROM AUTHOR]

Background: Given the health and social needs generated by the COVID-19 pandemic, the Telehealth Network of Minas Gerais, Brazil, implemented a teleconsultation and telemonitoring program to assist patients with suspected or confirmed COVID-19, the TeleCOVID-MG program. The telemonitoring service was conducted by medical students, under the supervision of a physician. The main goal of this study was to analyze the experience of the students while collaborating on the aforementioned telemonitoring program. Methods: A questionnaire with 27 questions was developed to address the participation of the students in the telehealth program. The questionnaire included questions about the student's profile, the system usability, and the satisfaction in participating in such a telehealth program. The questionnaire was generated on Google Forms® platform and sent via email to each student who was part of the telemonitoring team. Results: Sixty students were included in the analysis (median age 25 years-old [interquartile range 24–26], 70% women). Of those, 61.6% collaborated on the telehealth program for more than 6 months, 65.1% performed more than 100 telemonitoring calls, 95.2% reported difficulties in contacting the patient through phone calls; 60.3% believe some patients might have felt insecure about being approached by medical students and not by graduate professionals; and 39.6% reported eventual system instabilities. The main strengths reported by the students were related to the system usability and to the self-perception of the quality of healthcare delivered to the patients. Even though 68.3% of the students mentioned technical difficulties, 96.6% reported that they were promptly solved. Finally, 98.3% believed that the program was useful and would recommend it to an acquaintance. Conclusion: This study reports a successful experience of undergraduate medical students in a COVID-19 telemonitoring program. Overall, the medical students were satisfied with their participation, especially considering the continuity of clinical practice remotely during a period of classes suspension during the COVID-19 pandemic and their important role in the assistance of patients from low-income regions, which has minimized the health system burden in an emergency context. [ABSTRACT FROM AUTHOR]

Background: With their unmatched ability to interpret and engage with human language and context, large language models (LLMs) hint at the potential to bridge AI and human cognitive processes. This review explores the current application of LLMs, such as ChatGPT, in the field of psychiatry. Methods: We followed PRISMA guidelines and searched through PubMed, Embase, Web of Science, and Scopus, up until March 2024. Results: From 771 retrieved articles, we included 16 that directly examine LLMs' use in psychiatry. LLMs, particularly ChatGPT and GPT-4, showed diverse applications in clinical reasoning, social media, and education within psychiatry. They can assist in diagnosing mental health issues, managing depression, evaluating suicide risk, and supporting education in the field. However, our review also points out their limitations, such as difficulties with complex cases and potential underestimation of suicide risks. Conclusion: Early research in psychiatry reveals LLMs' versatile applications, from diagnostic support to educational roles. Given the rapid pace of advancement, future investigations are poised to explore the extent to which these models might redefine traditional roles in mental health care. [ABSTRACT FROM AUTHOR]

Copyright of Scientific-Practical Journal of Medicine Vestnik KazNMU is the property of Asfendiyarov Kazakh National Medical University and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The article offers information on evidence-based approaches for treating insomnia disorder. Topics include the characteristics and diagnostic criteria of insomnia disorder; the endorsement of cognitive-behavioral therapy for insomnia (CBT-I) as the first-line treatment by the Australasian Sleep Association (ASA); and the availability of evidence-based treatment manuals, tailored recommendations for specific populations, and digital programs for delivering CBT-I.

Communication is fundamental to mental health services for every patient, caregiver and clinician interaction. Without adequate communication skills, the aspiration to inclusion, engagement and recovery is likely to fail. Speech and language therapists provide specialist knowledge directly with patients, and indirectly via clinicians and caregivers. The objective of this study was to explore current UK provision and practice of speech and language therapists supporting working age adults with mental health conditions. A ten question online survey was shared on social media and sent to a network of speech and language therapists interested in mental health services in September 2019. Responses were analysed using descriptive statistics supported by free text survey responses. From survey closing in March 2020, 96 responses were received from across the four UK nations describing widely varying services. Respondents reported concerning gaps in SLT provision, other professions not understanding the SLT role, but over 75% of respondents reported multidisciplinary ways of working. Risks associated with communication impairment are often overlooked. The understanding of mental health professionals about the role of speech and language therapists is patchy. Highlighting awareness amongst the mental health workforce about communication impairment will improve access to treatment and care for all patients. [ABSTRACT FROM AUTHOR]

To describe staff experiences with the use of videoconferences with forensic psychiatric outpatients during the COVID-19 pandemic. Semi-structured interviews with staff at forensic community services in the Region of Southern Denmark. Nine semi-structured staff interviews were conducted. Two main themes were identified through thematic analysis: Challenges due to technical uncertainty and the Use of videoconferences as support in clinical assessment and treatment. The second main theme also included a number of subthemes: Lack of opportunity for observation of a patient's overall situation; Compromise of nurses' professionalism; Limitation of disturbing stimuli means more focus on the conversation; Telephone contact vs. video contact—pros and cons; Expectations reflect attitudes; and Will professionalism be changed based on organizational and political perspectives? Staff opinions on use of videoconferences in psychiatric patients differed. The nurses in particular were concerned about whether professionalism could be maintained. Others experienced patients focusing more on the conversation when it took place via video because there were fewer disturbing elements. In general, expectations seem to influence attitudes toward using videoconferences. [ABSTRACT FROM AUTHOR]

This article explores the role of telemedicine in addressing health disparities. It acknowledges the potential of technology and social determinants of health in improving patient outcomes. Telemedicine has the ability to increase access to healthcare, especially for those with chronic conditions, but there are concerns about its effectiveness due to barriers like bias, distrust, and the digital divide. The article also discusses the impact of telemedicine on patient non-compliance and the importance of addressing bias in healthcare delivery. It highlights potential issues with telemedicine, such as depersonalization and insufficient training, and emphasizes the need for improvement in virtual care for better patient outcomes. [Extracted from the article]

Patient activation is associated with treatment adherence, self-accountability for healthcare and a healthy lifestyle change. Mobile health (m-Health) apps can lead to greater patient treatment adherence and health behaviour change. This study aimed to evaluate the health behaviour change of elderly people through a healthcare programme focused on activation with the support of technology. Three phases were conducted: (1) pre-intervention – design of the intervention protocol and the app, (2) intervention – randomised clinical trial with 41 overweight/obese elderly people. m-Health app-supported group psychotherapy was compared with group psychotherapy only and individual psychotherapy (control) and (3) post-intervention – statistical analysis, intervention's assistant interviews and app heuristics evaluation. By crossing the results, the study has shown that there was no significant difference in the activation level before and after intervention between groups. However, there was a significant increase from the initial mean score to the final one when considering the three groups together. Group therapy, whether with or without the support of the app, was more effective for behaviour change measured by the achievement of the goals, than individual psychotherapy. The lack of impact on group therapy with app support calls into question which and how much technology support is useful. [ABSTRACT FROM AUTHOR]

Background: There is limited evidence on the association between psychological distress, academic stress, and burnout among Saudi nursing students. Clarifying such an association is crucial to understanding the factors associated with psychological distress and developing interventions to prevent it. Aim: To explore the prevalence and association of psychological distress with academic stress and burnout among Saudi nursing students. Methods: A cross-sectional design was used, and 237 students participated from a nursing college in Riyadh, Saudi Arabia. Students' demographics; the Depression, Anxiety, and Stress Scale; the Academic Stress Inventory; and the Maslach Burnout Inventory were used for data collection. Results: Most of the participants reported no-to-mild depression, anxiety, and stress. Stress related to studying in groups, time management, emotional exhaustion, depersonalization, and personal accomplishment were the significant predictors of psychological distress, explaining 52.1% of the variance. Conclusions: This study suggest implementing tailored mental health screenings and support services for nursing students, embedding mental health professionals in the program, and using telehealth or mobile apps for remote monitoring to ensure comprehensive care for nursing students. Future research should consider these predictors while designing strategies to decrease psychological distress among students. [ABSTRACT FROM AUTHOR]

Background: Given the low usage of virtual health care prior to the COVID‐19 pandemic, it was unclear whether those living in rural locations would benefit from increased availability of virtual mental health care. The rapid transition to virtual services during the COVID‐19 pandemic allowed for a unique opportunity to examine how the transition to virtual mental health care impacted psychotherapy disruption (i.e., 45+ days between appointments) among individuals living in rural locations compared with those living in nonrural locations. Methods: Electronic health record and insurance claims data were collected from three health care systems in the United States including rurality status and psychotherapy disruption. Psychotherapy disruption was measured before and after the COVID‐19 pandemic onset. Results: Both the nonrural and rural cohorts had significant decreases in the rates of psychotherapy disruption from pre‐ to post‐COVID‐19 onset (32.5–16.0% and 44.7–24.8%, respectively, p < 0.001). The nonrural cohort had a greater reduction of in‐person visits compared with the rural cohort (96.6–45.0 vs. 98.0–66.2%, respectively, p < 0.001). Among the rural cohort, those who were younger and those with lower education had greater reductions in psychotherapy disruption rates from pre‐ to post‐COVID‐19 onset. Several mental health disorders were associated with experiencing psychotherapy disruption. Conclusions: Though the rapid transition to virtual mental health care decreased the rate of psychotherapy disruption for those living in rural locations, the reduction was less compared with nonrural locations. Other strategies are needed to improve psychotherapy disruption, especially among rural locations (i.e., telephone visits). [ABSTRACT FROM AUTHOR]

Empathy is thought to be reduced in videoconference (VC) compared to face-to-face (F2F) therapy. To empirically test this possibility, therapist and client ratings of empathy and its correlates were examined in VC and F2F sessions. Forty-eight students in clinical training programs were randomly assigned to the role of 'therapist' or 'client', forming 24 dyads. Each dyad completed a simulated clinical session in F2F and in VC and reported on empathy and telepresence. Both therapist and client ratings of empathy were significantly lower in VC compared to F2F. Therapist empathy correlated with telepresence, particularly its physical subcomponent, and therapeutic presence, but these associations were not found for clients. The relationship between empathy and telepresence was investigated further in a real-world study. Twelve clients met with clinical psychology trainees over VC and reported on empathy and telepresence. The associations between therapist empathy, total telepresence, and the physical component of telepresence were replicated. Again, client ratings of empathy and telepresence did not correlate. These results provide the first empirical evidence that empathy is reduced in VC teletherapy compared to F2F and highlight the connection between the degree of empathy felt by therapists and their sense of telepresence during teletherapy. [ABSTRACT FROM AUTHOR]

Objective: Telepsychiatry items in the Australian Medicare Benefits Schedule (MBS) were expanded following the COVID-19 pandemic. However, their out-of-pocket costs have not been examined. We describe and compare patient out-of-pocket payments for face-to-face and telepsychiatry (videoconferencing and telephone) MBS items for outpatient psychiatric services to understand the differential out-of-pocket cost burden for patients across these modalities. Methods: out-of-pocket cost information was obtained from the Medical Costs Finder website, which extracted data from Services Australia's Medicare claims data in 2021–2022. Cost information for corresponding face-to-face, video, and telephone MBS items for outpatient psychiatric services was compared, including (1) Median specialist fees; (2) Median out-of-pocket payments; (3) Medicare reimbursement amounts; and (4) Proportions of patients subject to out-of-pocket fees. Results: Medicare reimbursements are identical for all comparable face-to-face and telepsychiatry items. Specialist fees for comparable items varied across face-to-face to telehealth options, with resulting differences in out-of-pocket costs. For video items, higher proportions of patients were not bulk-billed, with greater out-of-pocket costs than face-to-face items. However, the opposite was true for telephone items compared with face-to-face items. Conclusions: Initial cost analyses of MBS telepsychiatry items indicate that telephone consultations incur the lowest out-of-pocket costs, followed by face-to-face and video consultations. [ABSTRACT FROM AUTHOR]

This paper describes a study that examined the affordances of an intercultural programme of telecollaboration to promote the intercultural and transcultural awareness of adolescent learners in Indonesia. Baker's (2015, 2022) model of twelve components of intercultural and transcultural awareness is applied to investigate the development of the learners' awareness as a result of their engagement in the programme. This paper begins with a review of the literature on intercultural and transcultural awareness in English Language Teaching and the description of a framework that is suitable for fostering awareness in the classroom through intercultural telecollaboration. Then, the discussion moves to the study that has been conducted following the guidelines and the features influencing an intercultural telecollaboration programme developed by Hoffstaedter and Kohn (2015), which provides a holistic framework not only for conducting pedagogical research, but also for designing an intercultural telecollaboration programme that aligns with the characteristics of the classroom context. Finally, the findings are contrasted with Baker's model in order to understand the extent to which the intercultural telecollaboration programme has promoted the learners' intercultural and transcultural awareness. [ABSTRACT FROM AUTHOR]

It is well established that the integration of behavioral healthcare into the medical home model improves patient outcomes, reduces costs, and increases resident learning. As academic health centers increasingly integrate behavioral healthcare, targeted training for interprofessional collaboration around behavioral healthcare is needed. Simulation educational approaches potentially can provide this training. Health service psychologists are well-poised to support this because of their specialized training in integrated healthcare. The present exploratory study aimed to evaluate existing simulation programs and develop recommendations for integrated behavioral health training and evaluation. Directors of ACGME accredited residency programs that are high utilizers of the medical home model (Pediatrics, Internal Medicine, Medicine/Pediatrics, Family Medicine) as well as Psychiatry residencies and medical schools with membership in the Society for Simulation in Healthcare were recruited to complete a 26-item survey to assess program usage of psychologists as part of simulation training for integrated behavioral healthcare services. Of 79 participants who completed initial items describing their training program, only 32 programs completed the entire survey. While many academic health centers offered integrated team and behavioral health simulations, few utilized psychology faculty in design, implementation, and evaluation. Other behavioral health providers (psychiatrists, social workers) were often involved in medical school and pediatric residency simulations. Few institutions use standardized evaluation. Qualitative feedback and faculty-written questionnaires were often used to evaluate efficacy. Survey responses suggest that psychologists play limited roles in integrated behavioral healthcare simulation despite their expertise in interdisciplinary training, integrated behavioral healthcare, and program evaluation. [ABSTRACT FROM AUTHOR]

Objective:To identify the perceptions of the patients who received alternative care by telepsychiatry at the Cayetano Heredia Hospital (HCH). Methods:This research consisted of two phases: (1) transcultural adaptation of the Telehealth Usability Questionnaire (TUQ) with three experts and (2) application of the questionnaire in 183 patients from psychiatry in HCH. Nonparametric tests were used to determine the association between variables. Results:We applied 20 questions to 60 men and 123 women, with a median age of 45. The ease of using the virtual consultation service, the comfort with its use, and the general satisfaction had a score of 6 out of 7 and are associated with the number of devices that patients have and their degree of education. The usefulness, communication by virtual means, and the solution of technical problems had scores higher than 6, being considered acceptable by the patients. Willingness to have a teleconsultation again was high and was associated with patient satisfaction with the consultation. Conclusions:Most patients were satisfied with telepsychiatry via telemonitoring during the COVID-19 pandemic. The usage of validated tools such as TUQ might be included as part of evaluations of new telemedicine services. [ABSTRACT FROM AUTHOR]

Medical anthropologists have not paid enough attention to the variation at the level of the individual practitioners of biomedicine, and anthropological critiques of biomedical psychiatry as it is practiced in settings outside the Global North have tended to depict psychiatrists in monolithic terms. In this article, we attempt to demonstrate that, at least in the case of India, some psychiatrists perceive limitations in the biomedical model and the cultural assumptions behind biomedical practices and ideologies. This paper focuses on three practitioners who supplement their own practices with local and alternative healing modalities derived from South Asian psychologies, philosophies, systems of medicine and religious and ritual practices. The diverging psychiatric practices in this paper represent a rough continuum. They range from a bold and confident psychiatrist who uses various techniques including ritual healing to another who yearns to incorporate more Indian philosophy and psychology in psychiatric practice and encourages students of ayurvedic medicine to more fully embrace the science they are learning to a less proactive psychiatrist who does not describe a desire to change his practice but who is respectful and accepting of ayurvedic treatments that some patients also undergo. Rather than simply applying a hegemonic biomedical psychiatry, these psychiatrists offer the possibility of a more locally-attuned, context sensitive psychiatric practice. [ABSTRACT FROM AUTHOR]

People's lived experiences of distress are complex, personal, and vary widely across cultures. So, too, do the terms and expressions people use to describe distress. This variation presents an engaging challenge for those doing intercultural work in transcultural psychiatry, global mental health, and psychological anthropology. This article details the findings of a study of common distress terminology among 63 Kannada-speaking Hindu women living in Mysuru, the second largest city in the state of Karnataka, South India. Very little existing scholarship focuses on cultural adaptation for speakers of Dravidian languages like Kannada; this study aims to fill this gap and support greater representation of this linguistic family in research on mental health, idioms of distress, and distress terminology. Between 2018 and 2019, we conducted a 3-phase study consisting of interviews, data reduction, and focus group discussions. The goal was to produce a non-exhaustive list of common Kannada distress terms that could be used in future research and practice to translate and culturally adapt mental health symptom scales or other global mental health tools. [ABSTRACT FROM AUTHOR]

Latinx families face unique barriers to accessing traditional youth mental health services and may instead rely on a wide range of supports to meet youth emotional or behavioral concerns. Previous studies have typically focused on patterns of utilization for discrete services, classified by setting, specialization, or level of care (e.g., specialty outpatient, inpatient, informal supports), yet little is known about how youth support services might be accessed in tandem. This analysis used data from the Pathways to Latinx Mental Health study – a national sample of Latinx caregivers (N = 598) from across the United States collected at the start of the coronavirus pandemic (i.e., May–June 2020) – to describe the broad network of available supports that are used by Latinx caregivers. Using exploratory network analysis, we found that the use of youth psychological counseling, telepsychology, and online support groups was highly influential on support service utilization in the broader network. Specifically, Latinx caregivers who used one or more of these services for their child were more likely to report utilizing other related sources of support. We also identified five support clusters within the larger network that were interconnected through specific sources of support (i.e., outpatient counseling, crisis, religious, informal, and non‐specialty). Findings offer a foundational look at the complex system of youth supports available to Latinx caregivers, highlighting areas for future study, opportunities to advance the implementation of evidence‐based interventions, and channels through which to disseminate information about available services. [ABSTRACT FROM AUTHOR]

Background: Prisoners are often associated with mental health and substance use disorders. Coercive measures are widely used in prison settings. The objective of this study was to compare inmates' perceptions and satisfaction with telepsychiatry versus face-to-face consultation and the effects of telepsychiatry on the use of coercive measures. The sample consisted of 100 male inmates from various backgrounds who had experienced both approaches of services (face to face and telepsychiatry). Method: The data were obtained through an interview where the individuals completed a Demographic Data Questionnaire, a Participant Satisfaction Questionnaire to assess satisfaction with face-to-face psychiatric services, and a Participant Satisfaction Questionnaire to assess their satisfaction with services offered via telepsychiatry. Additionally, calculations of time spent waiting for a face-to-face psychiatric evaluation and time spent in handcuffs and in confined spaces were made before and after the introduction of telepsychiatry. Results: Statistically significant improvements (all p-values < 0.001) were noted in waiting times, support for relapse prevention, follow up, quality of mental health care, quality of care in the management of psychiatric problems and related medication, behavior of psychiatrists, duration of the assessment, sense of comfort, and confidentiality. Telepsychiatry led to the elimination of time spent in handcuffs and in confined spaces (transport vehicles). Conclusion: According to the results of this study, telepsychiatry is an acceptable method of service delivery in correctional facilities and was associated with a reduction of coercive practices. [ABSTRACT FROM AUTHOR]

Background During the COVID-19 pandemic, resident didactics at many institutions, including ours, were transitioned from in-person to virtual. Objectives We aimed to examine dermatology residents' attitudes towards virtual didactics, assessing their satisfaction, impression of effectiveness and preference, along with factors correlating with these responses. Methods An online questionnaire was administered to dermatology residents at our institution 3–6 months following the transition to virtual didactics. Results The response rate was 26 of 31 residents (84%). Of the 26 respondents, 20 (77%) expressed satisfaction, 15 (58%) effectiveness and 12 (46%) a preference towards virtual didactics. Factors associated with satisfaction included feeling that virtual didactics positively impacted learning retention, represented time well spent and utilized high-quality images. Perception of effectiveness correlated with using high-quality images, baseline preference for online instruction and feeling engaged. Factors associated with preference for virtual didactics included having opportunities for critical thinking, using high-quality images and utilizing images applicable to teledermatology care. Advantages of virtual didactics included convenience, decreased commuting and easily hosting guest lecturers. Disadvantages included distractions/decreased focus, reduced social interaction and difficulty with communication. Conclusions Residents expressed satisfaction with, effectiveness of and some preference towards virtual didactics, which correlated with numerous factors relating to the learning environment, prior educational experiences and technology. Our findings suggest that it is reasonable to maintain a virtual didactic component as part of dermatology resident education. Furthermore, our data provide insights into strategies that residency programme directors and educators may consider when/if integrating virtual didactics into future educational curricula. [ABSTRACT FROM AUTHOR]

Background: Cognitive‐behavioral therapy (CBT) and serotonin reuptake inhibitors (SRIs) are recommended treatments for pediatric obsessive‐compulsive disorder (OCD), but their relative efficacy and acceptability have not been comprehensively examined. Further, it remains unclear whether the efficacy of in‐person CBT is conserved when delivered in other formats, such as over telephone/webcam or as Internet‐delivered CBT (ICBT). Methods: PubMed, PsycINFO, trial registries, and previous systematic reviews were searched for randomized controlled trials (RCTs) comparing CBT (in‐person, webcam/telephone‐delivered, or ICBT) or SRIs with control conditions or each other. Network meta‐analyses were conducted to examine efficacy (post‐treatment Children's Yale‐Brown Obsessive Compulsive Scale) and acceptability (treatment discontinuation). Confidence in effect estimates was evaluated with CINeMA (Confidence in Network Meta‐Analysis). Results: Thirty eligible RCTs and 35 contrasts comprising 2,057 youth with OCD were identified. In‐person CBT was significantly more efficacious than ICBT, waitlist, relaxation training, and pill placebo (MD range: 3.95–11.10; CINeMA estimate of confidence: moderate) but did not differ significantly from CBT delivered via webcam/telephone (MD: 0.85 [−2.51, 4.21]; moderate), SRIs (MD: 3.07 [−0.07, 6.20]; low), or the combination of in‐person CBT and SRIs (MD: −1.20 [−5.29, 2.91]; low). SRIs were significantly more efficacious than pill placebo (MD: 4.59 [2.70, 6.48]; low) and waitlist (MD: 8.03 [4.24, 11.82]; moderate). No significant differences for acceptability emerged, but confidence in estimates was low. Conclusions: In‐person CBT and SRIs produce clear benefits compared to waitlist and pill placebo and should be integral parts of the clinical management of pediatric OCD, with in‐person CBT overall having a stronger evidence base. The combination of in‐person CBT and SRIs may be most efficacious, but few studies hinder firm conclusions. The efficacy of CBT appears conserved when delivered via webcam/telephone, while more trials evaluating ICBT are needed. [ABSTRACT FROM AUTHOR]

Background:This document represents an updated collaboration between the American Psychiatric Association (APA) and the American Telemedicine Association (ATA) to create a consolidated update of the previous APA and ATA official documents and resources in telemental health, to provide a single guide on clinical best practices for providing mental health services through synchronous videoconference. Methods:A joint writing committee drawn from the APA Committee on Telepsychiatry and the ATA TMH Special Interest Group (TMH SIG). was convened to draft and finalize the guidelines. This document draws directly from the 2018 APA/ATA guide and the ATA s previous guidelines, selecting from key statements/guidelines, consolidating them across documents, and then updating them where indicated. Guideline approval was provided following internal review by the APA, the ATA, the Board of Directors of the ATA, and the Joint Reference Committee of the APA. Results:The guidelines contain requirements, recommendations, and actions that are identified by text containing the keywords "shall," "should," or "may." Conclusions:Compliance with these recommendations will not guarantee accurate diagnoses or successful outcomes. The purpose of this guide is to assist providers in providing effective and safe medical care founded on expert consensus, research evidence, available resources, and patient needs. [ABSTRACT FROM AUTHOR]

Background: Telephobia is a kind of anxiety disorder in which the individual is afraid of either answering or making telephone calls. This study was conducted to determine the prevalence of telephobia among medical students and to determine the association of socio-demographic and other factors with this disorder. Methods: A total of 320 undergraduate medical students were enrolled at a tertiary medical college in Western India, of which 300 (93.75%) responded to the survey. A stratified sampling strategy with the proportional allocation method was used in which 40 males and 20 females were selected from each year of students, spanning 5 years. A specially designed semi-structured questionnaire was used for the study, consisting of demographic data, purpose of using the internet, gadget used, and a 10-item telephobia questionnaire modified from the Severity Measure for Agoraphobia—Adult (SMA-A) Questionnaire to measure student’s avoidance of telephone calling and receiving. Results: The mean age of the study participants was 21.91 (±1.84) years, and most of the students were urban residents (184, 61.3%). The prevalence of mild, moderate, and severe telephobia was 33.0%, 7.67%, and 1.33%, respectively, giving an overall prevalence of 42%. Univariate analysis revealed that male gender (χ2 = 9.822, df = 3, p = 0.0201), higher duration of internet usage (χ2 = 41.15, df = 9, p value < 0.000), and viewing porn (χ2 = 15.94, df = 3, p = 0.0011) had significant association with higher severity of telephobia. Viewing of porn sites was reported by 65 (21.7%) medical students, exclusively among males. Conclusion: A prevalence of 9% moderate to severe telephobia among medical students is much alarming, which may aggravate further as the students move from academic to clinical settings. The phenomenon of telephobia needs further exploration, to find its determinants and predictors, especially among vulnerable populations. [ABSTRACT FROM AUTHOR]

Background: Suicidal attempt is a significant risk factor for future attempts, with the highest risk during the first-year post-suicide. Telepsychiatry has shown promise by providing easy access to evidence-based interventions during mental health crises. Aims: investigation the effectiveness of telehealth interventions in suicide prevention Methods: Four electronic databases (PubMed, Scopus, Web of Science, and Ovid) were systematically searched for studies on patients undergoing telepsychiatry intervention (TPI) up to June 2022. Following PRISMA guidelines, a systematic review and meta-analysis were conducted to investigate the effectiveness of telehealth interventions in suicide prevention. Continuous data were pooled as standardised mean difference (SMD), and dichotomous data were pooled as risk ratio using the random effects model with the corresponding 95% confidence intervals (CI). Results: Sixteen studies were included in the review. Most studies were case-control and randomised controlled trials conducted in Europe and North America. The findings of the studies generally showed that TPIs are effective in reducing suicide rates (odds ratio = 0.68; 95% CI [−0.47, 0.98], p =.04) and suicidal reattempts. The interventions were also found to be well-accepted, with high retention rates. Conclusion: Our results suggest that TPIs are well-accepted and effective in reducing suicide rates and reattempts. It is recommended to maintain telephone follow-ups for at least 12 months. Further research is needed to understand the potential of telepsychiatry in suicide prevention fully. [ABSTRACT FROM AUTHOR]

Existe un interés creciente en el potencial de la telemedicina (TM) como un medio alternativo a la consulta física. Aunque numerosos estudios prueban los beneficios de la TM en reumatología, no existen recomendaciones sobre su implementación en España. El objetivo de este estudio fue analizar la aplicación de la TM en consultas de reumatología en España. Estudio cualitativo, transversal, multicéntrico con metodología Delphi en 2 rondas de consultas. Se diseñó un cuestionario ad hoc estructurado que incluía enunciados sobre teleconsulta, teleconsulta de enfermería, teleasistencia, telerrehabilitación, telerradiología, teleeducación sanitaria, principales barreras, ventajas e inconvenientes de la teleeducación sanitaria y TM en artritis reumatoide. Los participantes fueron especialistas en reumatología que ejercían su labor asistencial en España. Los reumatólogos participantes (N = 80) tenían una edad media de 42,4 (± 9,0) años, con 12,6 (± 8,4) años de experiencia. Algunos de los aspectos de la TM que obtuvieron un mayor consenso fueron: La TM es útil para el seguimiento de algunos pacientes, ayudar a determinar si es necesaria una consulta presencial, o asistir a pacientes con artritis reumatoide si presentan baja actividad o en remisión; ciertos pacientes, como aquellos en su primera consulta o aquellos que presentan barreras digitales o deterioro cognitivo, deben ser atendidos presencialmente; la TM presenta algunas barreras técnicas y de acceso de los pacientes; la TM puede ser útil en enfermería y en la formación médica continuada. La TM puede ser beneficiosa para el tratamiento y seguimiento de los pacientes con enfermedades reumáticas, así como para aliviar la carga asistencial presencial en reumatología. There is growing interest in the potential of telemedicine (TM) as an alternative to physical consultation. Although numerous studies prove the benefits of TM in rheumatology, there are no recommendations on its implementation in Spain. The aim of this study was to analyze the application of TM in rheumatology consultations in Spain. Qualitative, cross-sectional, multicenter study with Delphi methodology in 2 rounds of queries. A structured ad hoc questionnaire was designed that included statements on teleconsultation, nursing teleconsultation, telecare, telerehabilitation, teleradiology, telehealth tele-education, main barriers, advantages and disadvantages of telehealth tele-education and TM in rheumatoid arthritis. The participants were rheumatology specialists practicing in Spain. The participating rheumatologists (N = 80) had a mean age of 42.4 (± 9.0) years, with 12.6 (± 8.4) years of experience. Some of the aspects of TM that obtained the greatest consensus were: TM is useful for follow-up of some patients, to help determine if a face-to-face consultation is necessary, or to assist patients with rheumatoid arthritis if they present low activity or in remission; certain patients, such as those in their first consultation or those who present digital barriers or cognitive deterioration, should be seen face-to-face; TM presents some technical and patient access barriers; TM can be useful in nursing and in continued medical education. TM can be beneficial for the treatment and follow-up of patients with rheumatic diseases, as well as for alleviating the face-to-face care burden in rheumatology. [ABSTRACT FROM AUTHOR]

Background: Obsessive-compulsive disorder is a mental disorder that leads to impairment in various cognitive functions. Telemental health is applied in providing several telemental health and psychiatric services. It can provide health and psychological care, such as counseling, diagnosis, and treatment. Therefore, this study systematically examines the effectiveness of using a telemental health approach to manage obsessive-compulsive disorder. Methods: We searched PubMed, Web of Science, and Scopus using the keywords telepsychiatry, telemental health, telemedicine, telehealth, videoconferencing, obsessive-compulsive disorder, and OCD up to November 2023. In addition to searching the mentioned databases, references to related articles were also examined. Results: In this study, based on the search strategy, we identified 130 articles, 4 duplicate articles were removed, and the title and abstract of 126 articles were reviewed. Considering the selection criteria, 104 articles were excluded and 22 articles were included in the study. In 77.27% of the articles, videoconference telecommunication methods were used for communication. In 8 articles, the participants were children and adolescents. Reviewing these studies indicates mentions concerning the effectiveness of this method in most of them. Conclusions: In general, telemental health interventions increase access to treatment and can be promising for patients with certain conditions. This systematic review contributes to the expanding literature indicating that delivering CBT through telemental health methods, particularly videoconference-based approaches, is a feasible substitute for in-person treatments. [ABSTRACT FROM AUTHOR]